Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH EBU 6FR 3.0 LA6EU30

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270636541
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CATH EBU 6FR 3.0 LA6EU30

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636541N
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

CATH EBU 6FR 3.0 LA6EU30

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636541N
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$245.04
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

CATH EBU 6FR 3.5 LA6EBU35

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636542N
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

CATH EBU 6FR 3.5 LA6EBU35

Facility

$215.00

Service Code	HCPCS C1887
Hospital Charge Code	270636542
Hospital Revenue Code	278
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$47.30
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

CATH EBU 6FR 3.5 LA6EBU35

Facility

$215.00

Service Code	HCPCS C1887
Hospital Charge Code	270636542
Hospital Revenue Code	278
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$47.30
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

CATH EBU 6FR 3.5 LA6EBU35

Facility

$650.00

Hospital Charge Code	270636542C
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

CATH EBU 6FR 3.5 LA6EBU35

Facility

$650.00

Hospital Charge Code	270636542C
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH EBU 6FR 3.5 LA6EBU35

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636542N
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$245.04
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

CATHEBU 6FR 4.0 LA6EBU40

Facility

$215.00

Service Code	HCPCS C1887
Hospital Charge Code	270636543
Hospital Revenue Code	278
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$47.30
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

CATHEBU 6FR 4.0 LA6EBU40

Facility

$215.00

Service Code	HCPCS C1887
Hospital Charge Code	270636543
Hospital Revenue Code	278
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$47.30
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

CATH.EBUSIDE 6FR3.0 LA6EBU30SH

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636544
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$245.04
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

CATH.EBUSIDE 6FR3.0 LA6EBU30SH

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636544
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

CATH.EBU.SIDE6FR3.5 LA6EBU35SH

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636545
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$245.04
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

CATH.EBU.SIDE6FR3.5 LA6EBU35SH

Facility

$644.85

Service Code	HCPCS C1887
Hospital Charge Code	270636545
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

CATH.EBUSIDE6FR4.0 LA6EBU40SH

Facility

$644.85

Hospital Charge Code	270636546
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$245.04
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

CATH.EBUSIDE6FR4.0 LA6EBU40SH

Facility

$644.85

Hospital Charge Code	270636546
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

CATH EDM NUM LENGTHMARK BIO

Facility

$1,030.00

Hospital Charge Code	270703059
Hospital Revenue Code	270
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$154.50
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

CATH EDM NUM LENGTHMARK BIO

Facility

$1,030.00

Hospital Charge Code	270703059
Hospital Revenue Code	270
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$391.40
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.00
Rate for Payer: Oxford Commercial	$206.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Commercial	$206.00
Rate for Payer: UnitedHealthcare Community & State	$24.82
Rate for Payer: Wellpoint Medicaid Managed Care	$27.30

CATH EKOSONIC MACH 4 12x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642113C
Hospital Revenue Code	278
Min. Negotiated Rate	$342.82
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$342.82
Rate for Payer: Wellpoint Medicaid Managed Care	$376.96

CATH EKOSONIC MACH 4 12x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642113C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642113
Hospital Revenue Code	278
Min. Negotiated Rate	$342.82
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$342.82
Rate for Payer: Wellpoint Medicaid Managed Care	$376.96

CATH EKOSONIC MACH 4 12x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642113
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687S
Hospital Revenue Code	278
Min. Negotiated Rate	$342.82
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$342.82
Rate for Payer: Wellpoint Medicaid Managed Care	$376.96

Know your out-of-pocket cost for care.

All Charges